儿茶酚胺在蛛网膜下腔出血应激性心肌病的临床研究  

Clinical study of catecholamine in stress cardiomyopathy after subarachnoid hemorrhage

作　　者：张妙 尹泽黎[1] 刘洋 ZHANG Miao;YIN Ze-li;LIU Yang(Department of Neurology,Xiangdong Hospital Affiliated to Hunan Normal University,Zhuzhou Hunan 412200,China)

机构地区：[1]湖南师范大学附属湘东医院神经内科,湖南株洲412200

出　　处：《医学食疗与健康》2021年第3期13-15,共3页Medical Diet and Health

基　　金：湖南省教育厅科学研究项目(编号:19C1180)。

摘　　要：目的:观察蛛网膜下腔出血应激性心肌病患者不同时间点血浆儿茶酚胺的变化规律,及不同时间点血浆儿茶酚胺与超声心动图左室射血分数、N末端B型利钠肽原(NT-proBNP)的关系。方法:选取2018年10月至2020年11月在湖南师范大学附属湘东医院收治的符合条件的蛛网膜下腔出血患者共117例,根据是否发生应激性心肌病或急性心肌梗死分组,分为应激性心肌病组(A组)、急性心肌梗死组(B组)、对照组(未发生应激性心肌病及急性心肌梗死)三组(C组),其中发生应激性心肌病组12例,发生急性心肌梗死组4例,对照组101例,收集基本资料,包括姓名、性别、年龄、血压、心率、身高、体重测量、入院时进行GCS评分、Hunt-Hess分级等。收集所有入组患者入院24h内的血浆儿茶酚胺及所有入组患者的第1d、第3d或第5d、第7d血浆儿茶酚胺。分析蛛网膜下腔出血应激性心肌病中血浆儿茶酚胺的变化规律。结果:蛛网膜下腔出血应激性心肌病的发生率是10.2%,急性心肌梗死发生率是3.4%。未出现应激性心肌病也未发生急性心肌梗死是86.4%;蛛网膜下腔出血应激性心肌病在发病一周内儿茶酚胺随时间逐渐下降;结论:蛛网膜下腔出血应激性心肌病患者在发病一周内儿茶酚胺随时间逐渐下降且高于急性心肌梗死组和蛛网膜下腔出血组。为应激性心肌病诊断提供临床依据。Objective:To observe the changes of plasma catecholamine at different time points in patients with subarachnoid hemorrhage stress cardiomyopathy,and the relationship between plasma catecholamine and left ventricular ejection fraction and N-terminal B-type natriuretic peptide(NT-probNP)on echocardiography at different time points.Method:selection in October 2018 to 2020 in November in which hospital affiliated to hunan normal university were eligible,A total of 117 patients with subarachnoid hemorrhage,according to whether the stress cardiomyopathy or acute myocardial infarction group,divided into stress cardiomyopathy group(group A)and acute myocardial infarction group(group B),the control group(not stress cardiomyopathy and acute myocardial infarction)three groups(group C),including 12 cases occurred stress cardiomyopathy group,4 cases of acute myocardial infarction group,control group 101 examples,collect basic data,Including name,sex,age,blood pressure,heart rate,height,weight measurement,GCS score on admission,hunt-Hess grading,etc.Plasma catecholamines were collected from all enrolled patients within 24 hours of admission and from all enrolled patients on day 1,day 3,or day 5,and day 7.To analyze the changes of plasma catecholamine in stress cardiomyopathy after subarachnoid hemorrhage.Results:The incidence of stress cardiomyopathy due to subarachnoid hemorrhage was 10.2%,and the incidence of acute myocardial infarction was 3.4%.No stress cardiomyopathy or acute myocardial infarction occurred,86.4%;Catecholamines gradually decreased with time in stress cardiomyopathy due to subarachnoid hemorrhage within one week of onset;Conclusions:Catechenamine decreased gradually with time in patients with stress cardiomyopathy due to subarachnoid hemorrhage within one week of onset and was higher than acute myocardial infarction group and subarachnoid hemorrhage group.It provides clinical basis for the diagnosis of stress cardiomyopathy.

关 键 词：蛛网膜下腔出血 应激性心肌病 急性心肌梗死 血浆儿茶酚胺。 

分 类 号：R542.2[医药卫生—心血管疾病]